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Time to Follow-up Treatment of Photodynamic Therapy in Patients With Non-small Cell Lung Cancer
Lung Cancer SESSION TITLE: Lung Cancer II SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM
Time to Follow-up Treatment of Photodynamic Therapy in Patients With Non-small Cell Lung Cancer Ravishankar Jayadevappa PhD* Patrick Ross MD; and Sumedha Chhatre PhD University of Pennsylvania, Philadelphia, PA PURPOSE: We sought to analyze time to follow-up and sequence of treatment in non-small cell lung cancer (NSCLC) patients treated with photodynamic therapy (PDT) or non-PDT ablation therapy. METHODS: Retrospective cohort analysis using SEER-Medicare linked data. Patients with NSCLC diagnosed between 2000 and 2011were identified and retrospectively followed for one-year pre and up to ten-year post diagnosis. We analyzed the proportion of treatment that occurred during phases of care and sequence of PDT treatment. Primary outcome was time to follow-up surgery or radiation therapy after PDT or non-PDT ablation therapy. Patients who did not initiate follow-up treatment of surgery or radiation were censored. Time to treatment, variation in health service use and cost were compared between PDT and non-PDT ablation groups. We used GLM models to assess time to follow-up treatment and costs in follow-up period. Propensity score approach was used to minimize selection bias. RESULTS: Of the NSCLC cohort of 359,608, 136 patients received PDT with other treatments, and 1405 received non-PDT ablation with other treatments. In PDT group, 66% of the PDT treatment was within one year of NSCLC diagnosis. Forty-one percent of patients had surgery prior to PDT and 32% had radiation prior to PDT. In non-PDT ablation group, 75% of the treatment was within one-year of NSCLC diagnosis. Thirty-two% of patients had surgery prior to non-PDT ablation and 44% had radiation prior to non-PDT ablation. Unadjusted mean time to follow-up treatment was 235 days (SD 566) for PDT group and 147 days (SD 382) for non-PDT ablation group. In a GLM model, after adjusting for demographic and clinical characteristics, PDT group was associated with an average increase of 80 days in time to follow-up treatment (p¼0.0253) compared to non-PDT ablation group. Also, PDT was associated with 38% increase in cost, compared to non-PDT ablation group (p¼0.0014). CONCLUSIONS: PDT was associated with longer time to follow-up treatment compared to non-PDT ablation in patients with NSCLC. Currently, PDT is offered in various combinations with surgery and radiation. This demands further research to investigate the efficacy and effectiveness of these combinations in larger studies.
DISCLOSURE: Ravishankar Jayadevappa: University grant monies: Research Grant Patrick Ross: Grant monies (from industry related sources): Grant Sumedha Chhatre: Other: Consulting No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2016.08.808
Copyright ª 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
journal.publications.chestnet.org
713A
LUNG CANCER
CLINICAL IMPLICATIONS: Durability or time to follow-up treatment was higher with compared to non-PDT ablation in patients with NSCLC. Thus, addition of PDT to the treatment algorithm can be beneficial for patients with NSCLC.
Time to Follow-up Treatment of Photodynamic Therapy in Patients With Non-small Cell Lung Cancer Ravishankar Jayadevappa PhD* Patrick Ross MD; and Sumedha Chhatre PhD University of Pennsylvania, Philadelphia, PA PURPOSE: We sought to analyze time to follow-up and sequence of treatment in non-small cell lung cancer (NSCLC) patients treated with photodynamic therapy (PDT) or non-PDT ablation therapy. METHODS: Retrospective cohort analysis using SEER-Medicare linked data. Patients with NSCLC diagnosed between 2000 and 2011were identified and retrospectively followed for one-year pre and up to ten-year post diagnosis. We analyzed the proportion of treatment that occurred during phases of care and sequence of PDT treatment. Primary outcome was time to follow-up surgery or radiation therapy after PDT or non-PDT ablation therapy. Patients who did not initiate follow-up treatment of surgery or radiation were censored. Time to treatment, variation in health service use and cost were compared between PDT and non-PDT ablation groups. We used GLM models to assess time to follow-up treatment and costs in follow-up period. Propensity score approach was used to minimize selection bias. RESULTS: Of the NSCLC cohort of 359,608, 136 patients received PDT with other treatments, and 1405 received non-PDT ablation with other treatments. In PDT group, 66% of the PDT treatment was within one year of NSCLC diagnosis. Forty-one percent of patients had surgery prior to PDT and 32% had radiation prior to PDT. In non-PDT ablation group, 75% of the treatment was within one-year of NSCLC diagnosis. Thirty-two% of patients had surgery prior to non-PDT ablation and 44% had radiation prior to non-PDT ablation. Unadjusted mean time to follow-up treatment was 235 days (SD 566) for PDT group and 147 days (SD 382) for non-PDT ablation group. In a GLM model, after adjusting for demographic and clinical characteristics, PDT group was associated with an average increase of 80 days in time to follow-up treatment (p¼0.0253) compared to non-PDT ablation group. Also, PDT was associated with 38% increase in cost, compared to non-PDT ablation group (p¼0.0014). CONCLUSIONS: PDT was associated with longer time to follow-up treatment compared to non-PDT ablation in patients with NSCLC. Currently, PDT is offered in various combinations with surgery and radiation. This demands further research to investigate the efficacy and effectiveness of these combinations in larger studies.
DISCLOSURE: Ravishankar Jayadevappa: University grant monies: Research Grant Patrick Ross: Grant monies (from industry related sources): Grant Sumedha Chhatre: Other: Consulting No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2016.08.808
Copyright ª 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
journal.publications.chestnet.org
713A
LUNG CANCER
CLINICAL IMPLICATIONS: Durability or time to follow-up treatment was higher with compared to non-PDT ablation in patients with NSCLC. Thus, addition of PDT to the treatment algorithm can be beneficial for patients with NSCLC.